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Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach.

ABSTRACT: Researchers have extensively studied fatigue, depression and anxiety in cancer patients. Several risk and protective factors have been identified for these symptoms. As most studies address these constructs, independently from other symptoms and potential risk and protective factors, more insight into the complex relationships among these constructs is needed. This study used the multivariate network approach to gain a better understanding of how patients' symptoms and risk and protective factors (i.e. physical symptoms, social withdrawal, illness cognitions, goal adjustment and partner support) are interconnected. We used cross-sectional data from a sample of cancer patients seeking psychological care (n?=?342). Using network modelling, the relationships among symptoms of fatigue, depression and anxiety, and potential risk and protective factors were explored. Additionally, centrality (i.e. the number and strength of connections of a construct) and stability of the network were explored. Among risk factors, the relationship of helplessness and physical symptoms with fatigue stood out as they were stronger than most other connections in the network. Among protective factors, illness acceptance was most centrally embedded within the network, indicating it had more and stronger connections than most other variables in the network. The network identified key connections with risk factors (helplessness, physical symptoms) and a key protective factor (acceptance) at the group level. Longitudinal studies should explore these risk and protective factors in individual dynamic networks to further investigate their causal role and the extent to which such networks can inform us on what treatment would be most suitable for the individual cancer patient.

SUBMITTER: Schellekens MPJ

PROVIDER: S-EPMC7366596 | biostudies-literature | 2020 Aug

REPOSITORIES: biostudies-literature

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Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach.

Schellekens Melanie P J MPJ Wolvers Marije D J MDJ Schroevers Maya J MJ Bootsma Tom I TI Cramer Angélique O J AOJ van der Lee Marije L ML

Journal of behavioral medicine 20190822 4

Researchers have extensively studied fatigue, depression and anxiety in cancer patients. Several risk and protective factors have been identified for these symptoms. As most studies address these constructs, independently from other symptoms and potential risk and protective factors, more insight into the complex relationships among these constructs is needed. This study used the multivariate network approach to gain a better understanding of how patients' symptoms and risk and protective factor ...[more]

PMID: 31435892

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Project description:BackgroundAnxiety and depression often co-occur during adolescence, but the associations between symptoms of these two disorders in this developmental period are not yet fully understood. Network analysis provides a valuable approach to uncover meaningful associations among symptoms and offers insights for prevention and intervention strategies. This study aimed to investigate symptom-level associations between anxiety and depression using network analysis and to identify core symptoms, bridge symptoms, and differences in network structure across different stages of adolescence.MethodsThe cross-sectional study was conducted in March 2022 in Shenzhen, China. Participants completed the Generalized Anxiety Disorder Scale-7 and Patient Health Questionnaire Depression Scale, along with demographic questionnaires assessing age and gender. Chinese adolescents aged 10 to 17 who were in Grades 5 or 6 of elementary school, Grades 1 or 2 of middle school, or Grades 1 or 2 of high school, and who could comprehensively understand and read Chinese were recruited as participants. Students in Grade 3 of middle and high schools were excluded due to their upcoming high school or college entrance examinations. Based on age, participants were categorized into early, middle, and late developmental stages of adolescence.Results"Loss of control" was among the most central symptoms in the comorbidity network throughout all three developmental stages; "excessive worry" and "anhedonia" emerged as the core symptoms in early adolescence, and "restlessness" as the core symptom in late adolescence. "Anhedonia," "sad mood," and "fatigue" were identified as bridge symptoms between anxiety and depression across all three developmental stages of adolescence. The global strength of the network in middle adolescence was significantly higher compared to the other two stages.ConclusionThese findings highlight the core and bridge symptoms that require special attention and intervention at each stage of adolescence. Moreover, significantly higher network connectivity in middle adolescence suggests this is a critical period for intervention to prevent the development of comorbid mental disorders.

Project description:BACKGROUND:International research showed that common mental disorders such as depression, anxiety, social anxiety, stress, alexithymia and having insecure attachment styles are risk factors for alcohol use disorder (AUD). Our objective was to study the factors associated withAUD in a sample of the Lebanese population. METHODS:During the period lasting from November 2017 to March 2018, a sample of 789 Lebanese participants agreed to contribute to a cross-sectional study (53.23% males). Alcohol use disorder was assessed using the Alcohol Use Disorder Identification Test (AUDIT). RESULTS:A high risk of AUD was associated with higher alexithymia (ORa?=?1.030; CI 1.009-1.051), depression (ORa?=?1.076; CI 1.050-1.103) and suicidal ideation (ORa?=?1.253; CI 1.026-1.531) in a significant manner. In opposition, a higher number of kids (ORa?=?0.863; CI 0.752-0.991), being a female (ORa?=?0.460; CI 0.305-0.694) and higher emotional management (ORa?=?0.962; CI 0.937-0.988) were significantly associated with lower AUD risk. A cluster analysis derived three mutually exclusive clusters. Cluster 1 formed 45.4% of the sample and assembled people with psychological difficulties (work fatigue and high stress, high emotional work fatigue and low emotional intelligence, low self-esteem, high social phobia, high alexithymia); Cluster 2 formed 34.4% of the sample and assembled people with high wellbeing (low suicidal ideation, low emotional work fatigue, depression and anxiety, high emotional intelligence, high self-esteem and low social phobia); whereas cluster 3 formed 20.2% of the sample and represented people with mental dysfunction (high anxiety and depression, high suicidal ideation, low self-esteem and high social phobia, low emotional intelligence, high emotional work fatigue). People with psychological difficulties (cluster 1) (Beta?=?5.547; CI 4.430-6.663), and people in distress (cluster 3) (Beta?=?7.455; CI 5.945-8.965) were associated with higher AUDIT scores than those with high wellbeing (cluster 2). CONCLUSION:AUD seems to be influenced by several factors among the Lebanese population, including alexithymia, stress, anxiety and work fatigue. Healthcare professionals should spread awareness to reduce the prevalence of these factors.

Dataset Information

Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach.

Publications

Exploring the interconnectedness of fatigue, depression, anxiety and potential risk and protective factors in cancer patients: a network approach.

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